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1891790168

NPI Code Detail

MEDICARE: DR. ROBERT P NUTTALL MD

MEDICARE: DR. ROBERT P NUTTALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085P0229X	Pediatric Radiology Physician	00014815	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00107083	OTHER	AL	RAILROAD MEDICARE UAB

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	511-61184	OTHER	AL	BLUE CROSS
3	051516677	OTHER	AL	BCBS AL (UAB)
4	515-16677	OTHER	AL	BLUE CROSS
6	630842160	OTHER	AL	AETNA
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	515-90119	OTHER	AL	BLUE CROSS
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	515-20581	OTHER	AL	BLUE CROSS
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
14	515-17616	OTHER	AL	BLUE CROSS
15	515-17618	OTHER	AL	BLUE CROSS

General Provider Information

NPI Number	:	1891790168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT P NUTTALL MD

Provider Business Mailing Address
First Line	:	2000A SOUTHBRIDGE PKWY
Second Line	:	STE 300
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-7718
Country	:	US
Telephone Number	:	205-871-4274
Fax Number	:	205-871-4301

Provider Business Practice Location Address
First Line	:	1600 7TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35233-1711
Country	:	US
Telephone Number	:	205-939-9665
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	12/30/2015

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Directions to “ DR. ROBERT P NUTTALL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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